MEDICARE: PREMIER HEALTH ASSOCIATES, INC.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	I10279	OTHER	IA	NORIDIAN MEDICARE PART B

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	66519	OTHER	IA	WELLMARK BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1831167782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HEALTH ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	1454 30TH ST
Second Line	:	SUITE 103
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1312
Country	:	US
Telephone Number	:	515-223-6620
Fax Number	:	515-222-3962

Provider Business Practice Location Address
First Line	:	1454 30TH ST
Second Line	:	SUITE 103
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1312
Country	:	US
Telephone Number	:	515-223-6620
Fax Number	:	515-222-3962

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. LYNN TREASE JANSSEN
Credential	:	ED.D., CCC-SLP
Telephone Number	:	515-223-6620

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	09/15/2008

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308